Tag Archives: exercise

Dr Fang Qin Goh Introduction With semi-professional sporting events becoming more accessible,1 the effect of endurance training on the body is increasingly relevant, not just in elite athletes, but also fitness enthusiasts. Exercise prevents and aids treatment of coronary heart disease (CHD), hypertension, heart failure, diabetes mellitus, obesity and depression,2,3 reduces cardiac events,1 and improves survival.4,5 However, there is concern excessive exercise could have adverse cardiac effects.2 This article aims to address whether an upper limit to mortality benefits of exercise exists, consider physiological and potentially pathological ch

Introduction Hypertrophic cardiomyopathy (HCM) predominantly results from genetic variants that affect cardiac sarcomeres. The result is a heterogeneous condition characterised by ventricular hypertrophy that cannot be explained by increased afterload (i.e. arterial hypertension, aortic stenosis). Various hypothesised mechanisms were potentially responsible for a perceived increased risk of arrhythmia during exercise in patients with HCM: dynamic left ventricular outflow tract obstruction (LVOTO) increasing left ventricular pressure and strain; sympathetic vagal imbalance; microvascular ischaemia and metabolic acidosis.1 Subsequent internatio

Professor John B Chambers Introduction Aortic stenosis (AS) is the most common type of primary heart valve disease in industrialised countries. Although echocardiography is key for its assessment, the need for surgery is most frequently dictated by symptoms.1 However, the history can be surprisingly elusive, and physicians without specialist competencies in valve disease may miss their onset.2 This is important because the risk of death is approximately 1% per annum without symptoms but 4% in the first three months after the onset of symptoms,3 usually before the patient has time to contact their physician (figure 1). It then rises up to 14%

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BSH Parliament day Professor Andrew Clark (President of the British Society for Heart Failure) is pictured here (centre) carrying out an echocardiogram in the House of Commons. He was at a BSH event to help raise awareness that a person diagnosed with heart failure is likely to have a worse prognosis than if they were diagnosed with most cancers. This is despite the availability of specialist heart failure services that can have a remarkable impact on a patient’s chance of survival, but for which there is inconsistent access over the UK leading to wide variations in care and outcomes. Over 60 MPs, Peers, and professional and patient groups

Caffeine intake may reduce risk of type 2 diabetes Coffee and caffeine intake may significantly reduce the incidence of type 2 diabetes, according to a new meta-analysis published in the European Journal of Clinical Nutrition.  Pertinent studies were identified by a search of PubMed and EMBASE. The fixed- or random-effect pooled measure was selected based on between-study heterogeneity. Dose–response relationship was assessed. Commenting on the implications of this study (doi: 10.1007/s00394-013-0603-x), London general practitioner Dr Sarah Jarvis said: “There is growing evidence to suggest that moderate coffee consumption, that’s four

ESC backs regulations for medical devices The European Society of Cardiology has said in a position paper that it welcomes the European Commission’s (EC) proposals for a new Regulation to govern the evaluation and approval of medical devices in Europe as an important step towards improving patient safety. The EC proposal document is available at http://ec.europa.eu/health/medical-devices/documents/revision/index_en.htm New risk analysis scoring system A new risk scoring system, based on the SMART study, allows doctors to determine more accurately the risk of cardiovascular disease patients developing a new event, such as heart attack or str

Introduction Exercise is well recognised as a tool for assessment, prevention and management of cardiovascular disease.1 Cardiac patients are encouraged to attend cardiac rehabilitation programmes including elements of supervised exercise. Such programmes can reduce mortality and morbidity rates by up to 27%.2,3 Despite the benefits derived from participation in exercise-based cardiac rehabilitation, exercise itself may act as a trigger for myocardial ischaemia or cardiac arrest in patients with established coronary heart disease.4 During rehabilitation, cardiovascular event rates range from 12.3 to 37.4 per million patient hours of exercise.

Historically, CR programmes have been under funded and under resourced; this has resulted predominantly from the absence of a CR specific tariff resulting in the inclusion of the service into the broader cardiology tariff or service level agreements between commissioners and providers. This could be about to change with the proposed introduction of payment by results recognising CR programmes as cost-effective interventions that produce substantial health benefits.2 Resources Resources, at the most basic level, are defined as appropriately qualified staff to deliver exercise programmes within suitable venues. Current recommendations for exerc

This supplement is a report from the inaugural meeting of the Cardiometabolic Forum, jointly organised by the British Journal of Cardiology and HEART UK – The Cholesterol Charity. The meeting was held at the Royal Pharmaceutical Society, London, on 24th November 2011. Meeting chairs were Dr Dermot Neely (Royal Victoria Infirmary, Newcastle upon Tyne) for HEART UK, and Dr Henry Purcell (Royal Brompton Hospital, London, and Editor) for BJC. We hope this supplement will provide readers with an independent overview on recent developments in our knowledge of cholesterol metabolism and its implications for clinical practice. Speakers Dermot Neely